“It is better to be safe than sorry.”  Our mothers’ admonition rings in every one of our ears.  And it is an apt one for children unable to appreciate and weigh risks.  But the reality is that we live in a world full of risks.  Every day we take risks, most of which could be avoided, as a tradeoff for something we need or want.  We do it on an individual and a societal level.

For example, we know that there are virtually no traffic fatalities at speeds of less than 30 mph.  So, if we reduced the speed limit to 30 mph, we would save nearly all of the roughly 40,000 people in the US that die in car accidents each year.  If we were to put lowering the speed limit to 30 mph up for a vote, what do you think the result would be?

Or how about smoking.  According to the CDC, “cigarette smoking is responsible for more than 480,000 deaths per year in the United States, including more than 41,000 deaths resulting from secondhand smoke exposure. This is about one in five deaths annually, or 1,300 deaths every day.”  If we pass an outright ban on smoking, we could save nearly a half a million unnecessary deaths each year.  

Globally, two million people die every year in work-related accidents.  Should we shut down the world economy forever to save these two million lives?

The reality is that we put ourselves and others at risk every day for our livelihood, our convenience and our personal pleasure.  Implicit in those decisions is the uncomfortable calculus that we will tolerate some number of people dying as a trade-off for a variety of activities we undertake every day.

Of course, this is on my mind because of the current COVID-19 outbreak and various government restrictions that have been put in place to stem its spread.  At some point we will have to face the question of what level of COVID-19 risk we are willing to assume.

It is a calculus that we have already made when it comes to seasonal flu.  Before COVID-19, the CDC  estimated there would be 24,000-63,000 flu deaths this year in the U.S.  If we had adopted the same social distancing and stay-at-home protocols measures at the beginning of the flu season, a large percentage of those deaths could be avoided.  But if anyone would have suggested those measures at the beginning of flu season, they would have been laughed out of the room.

There are those who will attempt to portray the dilemma before us as a choice between saving lives and measly pecuniary interests.  I saw someone on social media recently say they would rather be poor and have their grandparents.  If it were only that simple.

Yes, of course, there are financial implications.  But they are not just about lowering our standard of living.  There are families that literally will not be able to feed themselves at some point under these restrictions.  Individuals will forego medical treatment because they cannot afford it, with unknowable consequences.  How many middle-class families will have their savings wiped out?  How many of their children will not be able to go to college as a result?  How many pension plans will go bankrupt because of the market collapse, leaving pensioners destitute?

But beyond the financial impact, there will also be unintended consequences from these measures we cannot even contemplate now.  For example, there were about 48,000 suicides last year.  My guess is that when we get those numbers for this year, we will see a big spike.  Alcohol sales have shot up.  How many more alcoholics will there be at the end of this?  Many expect there will be a surge in family violence.  How many cancers are not being diagnosed early enough to save a person’s life because routine screenings have been shut down.

The list of potential consequences is endless.

Hopefully, the course of the disease over the next couple of weeks will make the calculus less difficult.  If not, we will soon be facing some tough decisions.  But regardless of the exigency of the circumstance when that time comes, hopefully we will make those decisions with our gray matter and not our glands.

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Photograph by Rolland Hendrickson(1925-2014), Mother Scolds Her Daughter.